Individual provider Active NPI

Jeffrey Allen Kitchens

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1194225581
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901978 Issued in MS
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(601) 200-4644
Fax
(601) 200-4645
NPI assigned
Feb 13, 2018
Last updated
Feb 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 901978 MS Primary

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

PO Box 22727
Jackson, MS 39225-2727
Phone (601) 200-4749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180226001045 MS Practitioner - Nurse Practitioner 2264793777 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minor Med Care, LLCGroup PAC ID 7618866021, 77 clinicians
Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians
MDB Care Management LLCGroup PAC ID 0547619512, 4 clinicians

Practice addresses (Care Compare)

120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341

1727 E Union St
Greenville, MS 38703-3253
Phone (662) 537-4830

1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598

215 Katherine Dr
Suite a
Flowood, MS 39232-9588
Phone (601) 665-4162

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
MDB Care Management LLC CurrentSince Apr 1, 2025 Accepting new patients
Minor Med Care, LLC CurrentSince Feb 7, 2025 Accepting new patients
Uppal Medical Center LLC CurrentSince Apr 1, 2025 Accepting new patients
Minor Med Care, LLC CurrentSince Feb 7, 2025 Accepting new patients
MDB Behavioral Health Services LLC CurrentSince Feb 7, 2025 Accepting new patients
Heal All Wound Care LLC PastSince Mar 1, 2026 Accepting new patients

Locations

1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373

215 Katherine Dr
#A
Jackson, MS 39232

2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1194225581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22727",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392252727",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-4644",
            "fax_number": "601-200-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHENS",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.